Sobinsky Justin D, Willson Thomas D, Podbielski Francis J, Connolly Mark M
St. Joseph Hospital, Department of Surgery, 2900 North Lake Shore Drive, Chicago, IL 60657, USA.
Case Rep Oncol Med. 2013;2013:986517. doi: 10.1155/2013/986517. Epub 2013 Nov 10.
Invasive lobular carcinoma of the breast has similar patterns of metastatic disease when compared to invasive ductal carcinoma; however, lobular carcinoma metastasizes to unusual sites more frequently. We present a 65-year-old female with a history of invasive lobular breast carcinoma (T3N3M0) treated with modified radical mastectomy and aromatase-inhibitor therapy who underwent a surveillance PET scan, which showed possible sigmoid cancer. Colonoscopy with biopsy revealed a 3 cm sigmoid adenocarcinoma. The patient underwent a lower anterior resection. Pathology showed an ulcerated, invasive moderately differentiated adenocarcinoma extending into but not through the muscularis propria. However, six of seventeen paracolonic lymph nodes were positive for metastatic breast carcinoma (ER+/PR+), consistent with her lobular primary breast carcinoma; there was no evidence of metastatic colon cancer. This case highlights the unusual metastatic patterns of lobular carcinoma.
与浸润性导管癌相比，乳腺浸润性小叶癌具有相似的转移模式；然而，小叶癌更常转移至不常见的部位。我们报告一名65岁女性，有浸润性小叶乳腺癌（T3N3M0）病史，接受了改良根治性乳房切除术和芳香化酶抑制剂治疗，之后进行了PET监测扫描，结果显示可能存在乙状结肠癌。结肠镜检查及活检发现一处直径3 cm的乙状结肠腺癌。患者接受了低位前切除术。病理显示为溃疡性浸润性中度分化腺癌，累及但未穿透固有肌层。然而，17个结肠旁淋巴结中有6个存在转移性乳腺癌（雌激素受体阳性/孕激素受体阳性），与她的小叶性原发性乳腺癌相符；未发现转移性结肠癌的证据。该病例突出了小叶癌不寻常的转移模式。
